2022-11-07T12:36:33-06:00 2021-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2021-01-01 946050274 BARTON HEALTHCARE SYSTEM BART 5305413420 PO BOX 9578 SOUTH LAKE TAHOE CA 96158 KELLY NEIGER CFO 5305413420 2022-11-03 1 KELLY NEIGER 999009999 TERRI REXRODE CPA MST P00096513 9206620016 2022-10-30 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CLINTON PURVANCE MD PO BOX 9578 SOUTH LAKE TAHOE CA 96158 291865433 0 X WWW.BARTONHEALTH.ORG X 1960 CA MISSION: BARTON HEALTH DELIVERS SAFE, HIGH QUALITY CARE AND ENGAGES THE COMMUNITY IN THE IMPROVEMENT OF HEALTH AND WELLNESS. VISION: BARTON HEALTH IS THE COMMUNITY HEALTH LEADER KNOWN FOR COMPASSION AND CHOSEN FOR QUALITY. 10 9 1085 70 0 0 11714384 5987100 178394162 207155820 3144409 12220345 211261 3234847 193464216 228598112 657723 483618 0 0 89281222 94143685 0 0 0 90165419 111822938 180104364 206450241 13359852 22147871 331957060 350905731 57686920 57119233 274270140 293786498 X MISSION: BARTON HEALTH DELIVERS SAFE, HIGH QUALITY CARE AND ENGAGES THE COMMUNITY IN THE IMPROVEMENT OF HEALTH AND WELLNESS. VISION: BARTON HEALTH IS THE COMMUNITY HEALTH LEADER KNOWN FOR COMPASSION AND CHOSEN FOR QUALITY. 1 0 148210780 483618 198042584 BARTON HEALTHCARE SYSTEM (BARTON HEALTH) IS A 501( C)(3) COMMUNITY HEALTH SYSTEM THAT INCLUDES A LICENSED 63-BED FULL-SERVICE, GENERAL ACUTE CARE HOSPITAL WITH A 24-HOUR EMERGENCY ROOM; 48 BED SKILLED NURSING AND LONG TERM CARE FACILITY; AND 23 AMBULATORY OUTPATIENT CLINICS. BARTON HEALTH IS A BI-STATE HEALTH SYSTEM SERVING THE GREATER LAKE TAHOE REGION IN ADDITION TO TRANSIENT-BASED PATIENTS. NINE VENTILATORS AND EIGHT EMERGENCY RESCUE VENTILATORS WERE ALSO ON-HAND.BARTON HEALTH PROVIDES EXCEPTIONAL MEDICAL CARE REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY.THE FOLLOWING PROGRAMS ARE COMMUNITY OUTREACH PROGRAMS THAT BENEFIT THE HEALTH OF BARTON HEALTH LAKE TAHOE SOUTH SHORE COMMUNITY.COMMUNITY HEALTH EVENTS: BARTON HEALTH PROVIDES FREE OR DISCOUNTED SERVICES AT COMMUNITY HEALTH EVENTS INCLUDING COMMUNITY HEALTH FAIRS, LAB DRAWS, MAMMOGRAMS, EKG TESTS, VACCINATION CLINICS, CANCER WELLNESS PROGRAM, AND COMMUNITY EVENT MEDICAL SERVICES. YOUTH PROGRAMS: BARTON HEALTH PROMOTES HEALTH WITHIN YOUTH POPULATIONS THROUGH PROGRAMS THAT EDUCATE ABOUT THE RAMIFICATIONS OF DRUG AND ALCOHOL USE; DRUNK DRIVING; THE SPONSORSHIP OF YOUTH ACTIVITIES THAT PROMOTE HEALTH; FREE SPORTS PHYSICALS; SPORTS INJURY PREVENTION; AND HEALTH CAREER PROMOTION ACTIVITIES. COMMUNITY HEALTH EDUCATION PROGRAMS: MAILED COMMUNITY NEWSLETTER; MAILED COMMUNITY BENEFIT REPORT, FREE ONLINE E-NEWSLETTERS AND HEALTH LIBRARY; CHILDBIRTH EDUCATION CLASSES; CHILD/INFANT CPR AND FIRST-AID; NEW MOM'S SUPPORT PROGRAM; AND FREE VIRTUAL COMMUNITY HEALTH WEBINAR SERIES.COLLABORATION: ACCESS EL DORADO INVOLVING PUBLIC AND PRIVATE AGENCIES TO CREATE HEALTHIER COMMUNITIES ESPECIALLY WITHIN OUR VULNERABLE POPULATIONS; TELEHEALTH FOR TAHOE THAT BRINGS ADDITIONAL SPECIALTY HEALTH ACCESSIBLE THROUGH TELEMEDICINE; AND EMERGENCY MANAGEMENT COMMUNITY COUNCIL (BARTON HEALTH HOSTS AND CHAIRS) THAT MEETS WITH AREAS AGENCIES EVERY OTHER MONTH TO DISCUSS EMERGENCY PREPAREDNESS AND EDUCATION WITHIN OUR COMMUNITY. BARTON ADDITIONALLY PARTNERS WITH COVERED CALIFORNIA AS A CERTIFIED ENROLLMENT ENTITY THAT ASSISTS RESIDENTS WITH ENROLLING FOR HEALTH COVERAGE AT NO COST.COMMUNITY HEALTH IMPROVEMENT EFFORTS: BARTON LEADS THE COMMUNITY HEALTH ADVISORY COMMITTEE (25-MEMBER ALL VOLUNTEER COMMUNITY BOARD) WHICH IS FOCUSED ON IDENTIFYING AND THEN ADDRESSING UNMET HEALTH NEEDS. BARTON PARTICIPATES IN THE BEHAVIORAL HEALTH NETWORK (25-MEMBER ALL-VOLUNTEER COMMUNITY ADVISORY BOARD) WHICH IS FOCUSED PRIMARILY ON IDENTIFYING AND ADDRESSING THE GAPS IN OUR COMMUNITY'S MENTAL HEALTH SERVICES. IN ADDITION, THE BARTON FOUNDATION FUNDS THE BARTON HEALTH GRANTS PROGRAM WHICH PROVIDES $100,000 ANNUALLY TO AREA NONPROFITS THAT PROVIDE PROGRAMS AND SERVICES THAT CLOSELY ALIGN WITH OUR COMMUNITY'S NEEDS.LTUSD HEALTH AND WELLNESS TASKFORCE (1 MD AND 2 STAFF).IN RESPONSE TO THE CALDOR FIRE, BARTON HEALTH PARTNERED WITH SIERRA COMMUNITY HOUSE IN TRUCKEE TO PICK UP HIGH QUALITY PROTEINS AND PRODUCE TO PROVIDE FOOD FOR THE TAHOE COALITION FOR THE HOMELESS WHOSE CLIENTS HAD RETURNED TO SOUTH LAKE TAHOE AFTER BEING DISPLACED BUT BEFORE GROCERY STORES WERE OPEN. 5990594 0 8797978 THE BARTON COMMUNITY HEALTH CENTER PROVIDES ROUTINE MEDICAL CARE TO MEDICARE AND MEDI-CAL BENEFICIARIES, THOSE WITH INSURANCE BUT VERY HIGH DEDUCTIBLES OR THOSE WHO ARE UNINSURED. SAME DAY APPOINTMENTS ARE USUALLY AVAILABLE WHICH IMPROVES MEDICAL OUTCOMES. THE BARTON COMMUNITY HEALTH CENTER COMBINES THE EFFORTS OF NUMEROUS SKILLED PROFESSIONALS INCLUDING NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, MEDICAL ASSISTANTS, NURSES, OTHER MEDICAL SUPPORT STAFF, AND CONTRACTS WITH FAMILY AND SPECIALTY PHYSICIANS. SPECIALTY PHYSICIANS WHO SEE PATIENTS AT THE CLINIC INCLUDE PEDIATRICS, SLEEP MEDICINE, ORTHOPEDICS, OBSTETRICS, GYNECOLOGY, CHILD PSYCHIATRY, ADULT PSYCHIATRY, ADHD TREATMENT, UROLOGY, ENT, DERMATOLOGY, INFECTION DISEASE, PSYCHOLOGY, RHEUMATOLOGY, ENDOCRINOLOGY, AND NEUROLOGY. PATIENT ARE SOMETIMES UNDOCUMENTED MIGRANT WORKERS NOT ELIGIBLE FOR MEDI-CAL OR ARE INSURED LOW INCOME PATIENTS WITH VERY HIGH DEDUCTIBLES. UNDERINSURED AND UNINSURED PRIVATE PAY PATIENTS ARE CHARGED ON A SLIDING SCALE BASED ON INCOME AND SERVICES PROVIDED. BARTON'S COMMUNITY HEALTH CENTER SERVES AS A GATEWAY FOR PATIENTS IN NEED OF HEALTH CARE INCLUDING THOSE SEEKING FAMILY PLANNING SERVICES, PRECONCEPTION INFORMATION AND REFERRALS FOR STERILIZATION, LEVEL 1 INFERTILITY SERVICES, STD TREATMENT, REFERRALS FOR HIV SERVICES AND SCREENING FOR DES (DIETHYLSTILBESTROL) EXPOSURE. 1640878 0 0 THE HELPING HANDS PROGRAM ASSISTS PATIENTS OF BARTON MEMORIAL HOSPITAL WITH THEIR MEDICAL BILLS. IT MATCHES THE PATIENTS' ABILITY TO PAY ACCORDING TO THEIR UNIQUE CIRCUMSTANCE. PATIENTS ARE ASKED TO COMPLETE AN APPLICATION AND PROVIDE FINANCIAL INFORMATION ABOUT THEIR INCOME TO DETERMINE THEIR ABILITY TO PAY. THE DISCOUNT PATIENTS RECEIVE TOWARD THEIR MEDICAL BILL DEPENDS ON THEIR ADJUSTED GROSS INCOME COMPARED WITH THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES POVERTY INCOME GUIDELINES. THE PROGRAM IS DESIGNED FOR THOSE PATIENTS WHO CANNOT AFFORD THEIR MEDICAL BILLS, BARTON HEALTH PROVIDES DISCOUNTS FOR THOSE WITH INCOMES UP THE 350 PERCENT OF THE MOST RECENT POVERTY INCOME GUIDELINES, AND/OR UNDER SPECIAL CIRCUMSTANCES. DURING THE CURRENT YEAR THIS PROGRAM PROVIDED OVER $5.7 MILLION OF GROSS CHARGES IN CHARITY CARE. 155842252 1 1 0 1 0 0 0 1 0 1 1 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 0 0 1 347 0 1 1085 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 1 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 1 1 CA X X KELLY NEIGER 5305413420 PO BOX 9578 SOUTH LAKE TAHOE CA 96158 WENDY DAVID CHAIRMAN 5.00 X X 0 0 0 PATRICK FRY VICE CHAIRMAN 5.00 X X 0 0 0 ABBY KILLEBREW SECRETARY/TREASURER 5.00 X X 0 0 0 SHAWN ANDERSON TRUSTEE 5.00 X 0 0 0 PAT BAGHDIKAN TRUSTEE 5.00 X 0 0 0 KATHRYN BIASOTTI TRUSTEE 5.00 X 0 0 0 MIKE BRADFORD TRUSTEE (THROUGH 2/21) 5.00 X 0 0 0 KIRK LEDBETTER TRUSTEE 5.00 X 0 0 0 JEFF RAHBECK TRUSTEE 5.00 X 0 0 0 CHUCK SCHARER TRUSTEE 5.00 X 0 0 0 STEFAN SCHUNK TRUSTEE 5.00 X 26178 0 0 DENA SCHWARTE TRUSTEE (THROUGH 12/21) 5.00 X 0 0 0 CLINTON PURVANCE MD CEO 39.50 0.50 X 706363 256785 53565 KELLY NEIGER CFO 40.00 X 445045 82662 51737 MATTHEW WONNACOTT CHIEF MEDICAL OFFICER 40.00 X 597424 0 42275 JULIE CLAYTON CHIEF NURSING OFFICER 40.00 X 549684 0 34386 ELIZABETH STORK CHIEF HUMAN RESOURCES OFFICER 40.00 X 381296 112097 12349 DEANNA KYRIMIS CHIEF AMBULATORY OPERATIONS OFFICER (THROUGH 8/21) 40.00 X 652468 0 26314 DANA RANDALL PHYSICIANS ASSISTANT 40.00 X 214552 0 13122 JULIE HOWES CONTROLLER 40.00 X 241606 0 20284 SIOBHAN KELLER DIRECTOR OF NURSING 40.00 X 220582 0 39491 JEFFREY KOECK DIRECTOR OF PHARMACY 40.00 X 245330 0 41984 KAITLYN MIDDLEMIS-CLARK PHARMACIST 40.00 X 229898 0 6975 4510426 451544 342482 216 0 1 0 TAHOE CARSON VALLEY MEDICAL GROUP INC 2155 SOUTH AVENUE STE 24 SOUTH LAKE TAHOE CA 96150 PHYSICIAN SERVICES 18365823 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET OMAHA NE 68154 STAFF LABOR SERVICES 5406369 TAHOE ORTHOPEDICS & SPORTS PO BOX 11889 ZEPHYR COVE NV 89448 PHYSICIAN SERVICES 3889125 HEALTHSOURCE GLOBAL STAFFING INC 2735 COLLECTION CENTER DRIVE CHICAGO IL 60693 STAFF LABOR SERVICES 2580211 LAKE TAHOE ORTHOPAEDIC INSTITUTE INC PO BOX 11889 ZEPHYR COVE NV 89448 PHYSICIAN SERVICES 1931947 54 549651 5108648 328801 211600 5987100 NET PATIENT SERVICE REVENUE 621990 195085590 195085590 INVESTMENT IN WASHOE BARTON MEDIC 621110 10158223 10158223 SUPPORTING REVENUE 621990 1607279 1607279 CAFETERIA 722514 315258 315258 INVESTMENT IN ACO COLLABORATIVE L 621110 -10530 -10530 207155820 2574327 2574327 234664 0 234664 234664 234664 72853516 59823 63267321 0 9586195 59823 9646018 9646018 183 0 183 183 INSURANCE SETTLEMENT 900099 3000000 3000000 3000000 228598112 206840562 0 15770450 X 454760 454760 28858 28858 3559561 639699 2919862 70977845 51498857 19478988 2726280 2069979 656301 11616393 7740066 3876327 5263606 3761464 1502142 1647232 49252 1597980 69420 69420 245665 245665 52645112 42742382 9902730 449536 672 448864 7015617 4366576 2649041 4057692 618142 3439550 3703598 1754993 1948605 138858 123699 15159 403762 403762 10945653 10518603 427050 1012809 1012809 MEDICAL SUPPLIES 22205316 21990252 215064 NON-MEDICAL SUPPLIES 2300707 1837887 462820 BAD DEBT EXPENSE 897184 897184 LABOR STRIKE 315790 315790 3768987 3332356 436631 206450241 155842252 50607989 0 43175917 21500445 3602226 3399868 30578448 34410926 0 150000 4080857 4192255 2687472 3249497 245841169 124557624 108859626 121283545 73746325 54418166 15941538 44600449 36621551 47744218 12663100 15956362 331957060 350905731 18700901 25185922 16840198 12716004 2728839 3505221 19416982 15712086 57686920 57119233 X 274270140 293786117 0 381 274270140 293786498 331957060 350905731 22147871 -2631513 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 16446 16446 0 PART II-B, LINE 1: A PORTION OF BARTON HEALTHCARE SYSTEM'S MEMBERSHIP DUES PAID TO THE CALIFORNIA HOSPITAL ASSOCIATION AND THE CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS WAS USED FOR LOBBYING EXPENDITURES. 0 122999 X 0 3956633 12798 3969431 3848820 107813 176165 176165 3956633 3816534 28286 220734 216734 3848820 3738620 81914 152556 156556 3816534 3653815 84805 120793 120793 3738620 1.00000 0 1 1 9000000 21192310 30192310 117317614 56897591 60420023 6068523 2926676 3141847 82385413 62115652 20269761 122999 9754310 2617705 7259604 121283545 CHIC STOCK 98901 C INVESTMENTS - OTHER SECURITIES 44501548 F 44600449 INVESTMENT IN WASHOE BARTON MEDICAL CLINIC 46779774 C ACO COLLABORATIVE LLC STOCK 5500 C INVESTMENT IN BHC MSO LLC 958944 C 47744218 THIRD PARTY PAYORS 967436 CLAIMS RESERVE 6723412 OTHER LONG TERM OBLIGATIONS 200000 ADVANCE OF MEDICARE PAYMENTS 7821238 15712086 PART III, LINE 4: GENERAL PHOTOGRAPHS, PAINTINGS, ETC. ON DISPLAY FOR OUR PATIENTS AND GUESTS. PART V, LINE 4: BARTON MEMORIAL HOSPITAL FOUNDATION, INC., A RELATED 501(C)(3) ENTITY, HOLDS AN ENDOWMENT FUND IN WHICH THE EARNINGS ARE USED TO SUPPORT BARTON HEALTHCARE SYSTEM. 1 1 X 1 X 400.000000000000 1 X 400.000000000000 1 1 0 1 1 1315884 1315884 0.00640 32270898 29587163 2683735 0.01300 33586782 29587163 3999619 0.01940 987781 189319 798462 0.00390 461359 259275 202084 0.00100 1259748 4591893 0 0.00000 2708888 5040487 1000546 0.00490 36295670 34627650 5000165 0.02430 146684 146684 0.00070 1044347 146448 897899 0.00430 1838338 704404 1133934 0.00550 535338 535338 0.00260 3564707 850852 2713855 0.01310 1 897184 19426425 26417645 -6991220 X 1 1 1 WASHOE-BARTON MEDICAL CLINIC DBA CARSON VALLEY MEDICAL CENTER CRITICAL ACCESS HOSPITAL 0.50000 2 BHC MSO LLC MANAGEMENT SERVICES 1.00000 3 ACCOUNTABLE CARE COLLABORATIVE LLC OPERATE ACCOUNTABLE CARE ORGANIZATION THAT ARRANGES FOR THE PROVISION OF HE 1.00000 4 BARTON MEDICAL FOUNDATION ARRANGES FOR THE PROVISION OF HEALTHCARE SERVICES 1.00000 5 ACO COLLABORATIVE LLC FORMED AS A MEDICARE SHARED SAVINGS PROGRAM TO ACHIEVE BENEFICIARY IMPROVED 0.50000 1 1 BARTON MEMORIAL HOSPITAL 2170 SOUTH AVENUE SOUTH LAKE TAHOE CA 96150 WWW.BARTONHEALTH.ORG 030000013 X X X BARTON MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V, PAGE 8 X X 1 21 1 SEE PART V, PAGE 8 0 1 X 100.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.BARTONHEALTH.ORG/TAHOE/FINANCIAL-AID.ASPX X HTTPS://WWW.BARTONHEALTH.ORG/TAHOE/FINANCIAL-AID.ASPX X HTTPS://WWW.BARTONHEALTH.ORG/TAHOE/FINANCIAL-AID.ASPX X X X X X X 1 X 0 X X X X 1 X 0 0 BARTON MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: A COMMUNITY HEALTH PHONE SURVEY WAS CONDUCTED TO RECORD COMMUNITY FEEDBACK. THE SAMPLE DESIGN USED FOR THIS EFFORT CONSISTED OF A STRATIFIED RANDOM SAMPLE OF 400 INDIVIDUALS AGE 18 AND OLDER IN THE PRIMARY SERVICE AREA, SEPARATED INTO FOUR SUB-COMMUNITIES. ONCE THE INTERVIEWS WERE COMPLETED, THESE WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION SO AS TO APPROPRIATELY REPRESENT THE PRIMARY SERVICE AREA AS A WHOLE. ALL ADMINISTRATION OF THE SURVEYS, DATA COLLECTION AND DATA ANALYSIS WAS CONDUCTED BY PRC. ADDITIONALLY, TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. BARTON MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: COMMUNITY PRESENTATIONS TO CHAMBER LEADERSHIP, BARTON AUXILIARY, CITY COUNCIL, COMMUNITY BENEFIT ORGANIZATIONS, SERVICE CLUBS, ETC. BARTON MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: THE MOST RECENT CHNA, CONDUCTED IN 2021, IDENTIFIED 12 HEALTH NEEDS, WITH THE TOP THREE PRIORITIES BEING MENTAL HEALTH, SUBSTANCE ABUSE AND ACCESS TO CARE. WHILE ALL 12 NEEDS ARE BEING ADDRESSED, THE ACTION PLAN FOR THE TOP THREE ARE AS FOLLOWS: MENTAL HEALTH: WE HAVE 2 STRATEGIES AS PART OF OUR MENTAL HEALTH ACTION PLAN: STRATEGY 1: EXPAND AND CONTINUE TO PROVIDE MENTAL AND BEHAVIORAL HEALTH SERVICES. RECRUIT ADDITIONAL BEHAVIORAL HEALTH PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS FOR PATIENTS TRACK AND IMPROVE DEPRESSION SCREENING RATES AT ANNUAL WELLNESS VISITS PURSUE OPPORTUNITIES TO CONTINUE TELE-BEHAVIORAL HEALTH TREATMENT ACCESS FOR MEDI-CAL/CARE PATIENTS THROUGH HEALTHNET GRANT OR OTHER. EXPLORE WAYS TO INTEGRATE MENTAL AND BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE SETTINGS WITH ACES SCREENING STRATEGY 2: SPEARHEAD COMMUNITY COLLABORATION AND ENGAGEMENT TO ENSURE ALIGNMENT OF PROGRAMS AND SUPPORT. SPEARHEAD A SUBCOMMITTEE OF THE COMMUNITY HEALTH ADVISORY COMMITTEE ADDRESSING ACTIONABLE MENTAL AND BEHAVIORAL HEALTH ITEMS. SUBSTANCE ABUSE: WE HAVE 3 STRATEGIES FOCUSED ON ADDRESSING THIS PRIORITY: STRATEGY 1: DEVELOP AND MAINTAIN PATHWAYS ADDRESSING PAIN AND ADDICTION. EXPAND THE MEDICATION ASSISTED TREATMENT PROGRAM TO INCLUDE ADDITIONAL WAIVERED PROVIDERS AND AN EMERGENCY DEPARTMENT BRIDGE PROGRAM AS WELL AS ANY SUPPORTING PROGRAMS THAT HELP REDUCE OPIOID OVERDOSE CONTINUE THE SUBSTANCE USE NAVIGATOR ROLE TO HELP SUPPORT AND COORDINATE CARE FOR IN-PATIENT AND EXPAND TO OUT-PATIENT SETTINGS. SUPPORT ADDITIONAL PROGRAMS AT THE COMMUNITY HEALTH CENTER TO SUPPORT ADDICTION, SUCH AS OUTPATIENT ALCOHOL ABUSE PROGRAM-A MONTHLY INJECTION (VIVITROL) PURSUE OPIOID CARE HONOR ROLL DESIGNATION THROUGH THE CAL HOSPITAL COMPARE TO INCREASE ACCESS TO ADDICTION TREATMENT FOR HOSPITALIZED PATIENTS AND REDUCE OPIOID-RELATED DEATHS. PART OF THE PROGRAM INCLUDES TRAINING FOR HEALTHCARE PROFESSIONALS IN OPIOID SAFETY PRACTICES TO PREVENT NEW OPIOID STARTS, IDENTIFY AND TREAT OPIOID USE DISORDER, PREVENT OVERDOSE AND DEVELOP AN OVERALL CULTURE OF OPIOID SAFETY CONSIDER IMPLEMENTATION OF APPROPRIATE ALTERNATIVE THERAPIES TO PATIENTS THROUGHOUT THE BARTON HEALTH SYSTEM INCLUDING AROMATHERAPY, INTEGRATIVE MEDICINE, MEDITATION, MASSAGE THERAPY AND OTHERS UTILIZE PHYSIATRIST + ANESTHESIOLOGIST FOR NON-OPIOID PAIN MANAGEMENT EDUCATE THE IMPORTANCE OF ALTERNATIVE PAIN MANAGEMENT MODALITIES THROUGH PATIENT-FACING COLLATERAL AND ARTICLES STRATEGY 2: PARTICIPATE IN THE COORDINATED COMMUNITY GROUPS FOCUSED ON SUBSTANCE USE. ATTEND AND PARTICIPATE IN COMMUNITY MEETINGS ADDRESSING EDUCATION AND PREVENTION, INCLUDING TAHOE ALLIANCE FOR SAFE KIDS, EL DORADO COUNTY OPIOID COALITION, AND OTHERS SUPPORT COMMUNITY PREVENTION PROGRAMS AND FUND OPPORTUNITIES, INCLUDING DRUG STORE PROJECT, DEA DRUG TAKE BACK DAY AND OPIOID COALITION CONFERENCE SPEAKING PANEL SUPPORT GRANT FUNDING THAT SUPPORTS COMMUNITY EFFORTS TO HELP DRIVE EDUCATION AND SERVICES FOR SUBSTANCE USE STRATEGY 3: CONDUCT OUTREACH AND EDUCATION ON THE EFFECTS OF ALCOHOL AND DRUG USE. IMPLEMENT AWARENESS CAMPAIGN ANNUALLY THROUGH: LECTURES/WEBINARS, PRESENTATIONS AT THE LOCAL SCHOOLS, ARTICLES, ADVERTISEMENT, WEB AND SOCIAL MEDIA AWARENESS SUBSTANCE USE RESOURCES WILL BE INCLUDED IN THE HEALTH RESOURCE GUIDE UPDATED ANNUALLY CONTRIBUTE TIME, DATA AND OTHER RESOURCES TO FURTHER THE MISSION OF PREVENTION AND EDUCATION AND ENSURE SUCCESSFUL PROGRAM OUTCOMES. PARTICULAR PROGRAMS MAY INCLUDE: PERMANENT DRUG TAKE BACK BINS, IN-HOME LOCK BAGS, AN ALTERNATIVE SUSPENSION PROGRAM AT THE MIDDLE AND HIGH SCHOOLS, AND EDUCATING PARENTS ON THE DANGERS OF ALCOHOL AND DRUG USE FOR TEENAGERS THROUGH COMMUNITY PRESENTATIONS AND THE PARENT TEXTING NETWORK DISSEMINATE APPROPRIATE INFORMATION TO BARTON STAFF AND PHYSICIANS AND COORDINATE INTERNAL TRAININGS AS REQUESTED ACCESS TO CARE: WE HAVE 5 STRATEGIES DESIGNED TO ADDRESS THIS PRIORITY: STRATEGY 1: IDENTIFY ACCESS BARRIERS TO IMPROVE ACCESS STANDARDIZE DASHBOARD ILLUSTRATING BENCHMARKS FOR ACCESS INCLUDING THIRD NEXT AVAILABLE, OPEN PANELS, PROVIDER PATIENT APPOINTMENT VOLUME AND PERCENTAGE OF PCP ASSIGNMENTS INCREASE PRIMARY CARE PROVIDER AVAILABILITY FOR FIRST TIME PATIENTS. INCREASE APPOINTMENT AVAILABILITY THROUGH STANDARDIZING SCHEDULES, AND SUPPORTING PROVIDER EFFICIENCY EXPAND AFTER HOUR APPOINTMENTS WEEKDAYS AND WEEKENDS. RECRUIT PROVIDERS, AS NECESSARY, TO MEET DEMAND AND EXPAND SPECIALTY PROVIDERS. INCREASE MYCHART USAGE PERFORM ANALYSIS ON COMMUNITY HEALTH CARE CENTER EXPANSION TO BETTER MEET LOCAL NEEDS OF UNDERINSURED STRATEGY 2: EXPAND PATIENT-CENTERED CARE MODELS TO IMPROVE STANDARDIZATION AND CONTINUUM OF CARE CREATE STREAMLINED OPERATIONS ACROSS ALL PRIMARY CARE SETTINGS, TO PROVIDE EASIER ACCESS TO CARE THROUGH OPEN SCHEDULING, EXPANDED HOURS, AND INCREASED OPTIONS FOR COMMUNICATION BETWEEN PATIENTS, THEIR DOCTORS, AND SUPPORT STAFF IMPROVE ACCESS AND CARE COORDINATION THROUGH MEETING CRITERIA FOR THE PATIENT CENTERED MEDICAL HOME (PCMH) DESIGNATION AT BARTON FAMILY MEDICINE LOCATION ESTABLISH PCSP DESIGNATIONS TO OUTPATIENT SPECIALTY CLINICS TO CONTINUE CARE COORDINATION STRATEGY 3: INCREASE INSURANCE COVERAGE FOR THE COMMUNITY THROUGH OUTREACH FOR COVERED CALIFORNIA AND MEDI-CAL TRAIN AND MAINTAIN CERTIFICATION FOR BARTON HEALTH EMPLOYEES TO BECOME CERTIFIED ENROLLMENT COUNSELORS FOR COVERED CALIFORNIA MEDI-CAL COUNTY LIAISON TO HAVE OFFICE SPACE AND EDUCATION TO STAFF TO DIRECT PATIENTS FOR ENROLLMENT CONTINUE AS A RESOURCE FOR THE COMMUNITY TO ANSWER QUESTIONS AND ENROLL CONSUMERS INTO MEDICAL HEALTH COVERAGE PROVIDE EDUCATIONAL MARKETING MATERIALS AND ENSURE WEBSITE HAS INFORMATION REGARDING HEALTH INSURANCE OPTIONS FOR THE SOUTH LAKE TAHOE REGION STRATEGY 4: CREATE AND IMPLEMENT AN OUTREACH PLAN FOR THE LATINO COMMUNITY WORK WITH COMMUNITY PARTNERS SUCH AS FAMILY RESOURCE CENTER, SCHOOL DISTRICTS, LAKE TAHOE COMMUNITY COLLEGE, EL DORADO COUNTY COMMUNITY HUB, EL DORADO COUNTY SUBSTANCE USE DISORDER AND UC CALFRESH TO COORDINATE IDEAS AND PLANS TO BEST REACH AND EDUCATE THIS COMMUNITY HOST AND PARTNER IN COMMUNITY GATHERING EVENTS THAT BEST REACH AND SERVE OUR LATINO COMMUNITY REGULARLY PARTICIPATE IN PARENT CAFECITOS PROVIDE TIMELY EDUCATIONAL ARTICLES AND WEBINARS IN SPANISH PARTNER WITH COMMUNITY ORGANIZATIONS TO PROVIDE DIRECT MEDICAL RESOURCES, SUCH AS FLU CLINICS, COVID-19 VACCINATIONS, BLOOD WORK LABS, AND MORE STRATEGY 5: DEVELOP PLAN FOR STATELINE CAMPUS EXPANSION. EXPAND AVAILABILITY AND OFFICE HOURS FOR PRIMARY CARE PROVIDERS AND SPECIALTIES OFFICES AT STATELINE CAMPUS OPEN OUTPATIENT MRI OFFERING AFFORDABILITY AND CONVENIENCE, SIMILAR TO OTHER OUTPATIENT NEVADA FREE-STANDING LOCATIONS DEVELOP AND COMMUNICATE LONG TERM STRATEGY FOR STATELINE, NV CAMPUS WHILE BARTON HEALTH MAY NOT DIRECTLY WORK TO RESOLVE ALL HEALTH ISSUES IDENTIFIED, BARTON IS COMMITTED TO WORKING COLLABORATIVELY WITH COMMUNITY PARTNERS, WHENEVER POSSIBLE, TO HELP ADDRESS HEALTH NEEDS AS THEY OCCUR. BARTON MEMORIAL HOSPITAL PART V, SECTION B, LINE 15E: DISCLOSURE UNDER REVENUE PROCEDURE 2015-21:BARTON RECEIVED A COMPLIANCE CHECK INFORMATION REQUEST (REQUEST TYPE 8014) DATED 7/12/2021 FROM THE DEPARTMENT OF TREASURY INTERNAL REVENUE SERVICE. THE REQUEST NOTED THE FOLLOWING ITEMS IN REGARDS TO THE FINANCIAL ASSISTANCE POLICY (FAP): POSSIBLE MISSING FAP REQUIREMENTO THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. O IN THE CASE OF A HOSPITAL THAT DOES NOT HAVE A SEPARATE BILLING AND COLLECTION POLICY, ACTIONS THAT MAY BE TAKEN IN THE EVENT OF NONPAYMENT FAP PLAIN LANGUAGE SUMMARYO INSTRUCTIONS ON HOW AN INDIVIDUAL CAN GET A FREE COPY OF THE FAP AND FAP APPLICATION FORM BY MAIL. O A STATEMENT OF WHICH LANGUAGE TRANSLATIONS ARE AVAILABLE FOR THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP, IF APPLICABLE.O A STATEMENT THAT A FINANCIAL AP-ELIGIBLE INDIVIDUAL CAN'T BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED FOR EMERGENCY OR OTHER MEDICALLY-NECESSARY CARE.ON AUGUST 11, 2021 BARTON PROVIDED THE IRS WITH THE CURRENT FINANCIAL ASSISTANCE POLICY WHICH WAS APPROVED MARCH 2020 TO MEET THE REQUIREMENTS OF IRC SECTION 501(R)(4). BARTON ANNUALLY REVIEWS AND UPDATES AS NECESSARY THE FAP, FAP PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTION POLICY. BARTON ALSO VALIDATES THE DOCUMENTS ARE UPDATED THROUGHOUT THE ORGANIZATION AND ON THE WEBSITE. FORM 990, SCHEDULE H, PART V, LINE 7A THE ENTIRE WEBSITE ADDRESS IS:HTTPS://WWW.BARTONHEALTH.ORG/TAHOE/COMMUNITY-HEALTH.ASPX FORM 990, SCHEDULE H, PART V, LINE 10A THE FULL WEBSITE ADDRESS IS:HTTPS://WWW.BARTONHEALTH.ORG/UPLOADS/PUBLIC/DOCUMENTS/BARTONIMPLEMENTATIONSTRATEGY2021-SIGNED.PDF 23 1 - BARTON COMMUNITY HEALTH CENTER 2201 SOUTH AVENUE SOUTH LAKE TAHOE CA 96150 RHC, PRIMARY CARE, OB, PEDIATRICS, & SPECIALTY SERVICES 2 - BARTON CENTER OF ORTHOPEDICS AND WELLNES 2170 B SOUTH AVENUE SOUTH LAKE TAHOE CA 96150 ORTHOPEDICS, REHABILITATION, PERFORMANCE FITNESS, HEALTH & WELLNESS SERVICES 3 - LAKE TAHOE SURGERY CENTER 212 ELKS POINT ROAD STE 201 ZEPHYR COVE NV 89448 AMBULATORY SURGERY CENTER 4 - TAHOE ORTHOPEDICS AND SPORTS MEDICINE 935 MICA DRIVE BLDG C STE 13 14 CARSON CITY NV 89705 ORTHOPEDIC CLINIC, PHYSICAL MEDICINE & REHABILITATION 5 - BARTON HOME HEALTH & HOSPICE 2092 LAKE TAHOE BLVD STE 500 SOUTH LAKE TAHOE CA 96150 HOME HEALTH & HOSPICE SERVICES 6 - BARTON FAMILY MEDICINE 1090 THIRD STREET SOUTH LAKE TAHOE CA 96150 FAMILY PRACTICE CLINIC 7 - BARTON URGENT CARE & OCCUPATIONAL HEALTH 155 HIGHWAY 50 STATELINE NV 89449 URGENT CARE & OCCUPATIONAL HEALTH CLINIC 8 - BARTON MULTI-SPECIALTY CLINIC 1139 THIRD STREET SOUTH LAKE TAHOE CA 96150 GENERAL SURGERY, GASTROENTEROLOGY, CARDIOLOGY, PLASTIC SURGERY & NEUROLOGY 9 - BARTON UROLOGY 2169 SOUTH AVENUE SOUTH LAKE TAHOE CA 96150 UROLOGY CLINIC 10 - TAHOE ORTHOPEDICS AND SPORTS MEDICINE 212 ELKS POINT ROAD STE 200 ZEPHYR COVE NV 89448 ORTHOPEDIC CLINIC, PHYSICAL MEDICINE & REHABILITATION 11 - BARTON FAMILY MEDICINE 165 HIGHWAY 50 STATELINE NV 89449 FAMILY PRACTICE & INTERNAL MEDICINE 12 - TAHOE ORTHOPEDICS AND SPORTS MEDICINE 925 TAHOE BLVD STE 105-106 INCLINE VILLAGE CA 89451 ORTHOPEDIC CLINIC 13 - BARTON EAR NOSE & THROAT 2169 SOUTH AVENUE SOUTH LAKE TAHOE CA 96150 ENT & AUDIOLOGY CLINIC 14 - BEHAVIORAL HEALTH AND TELEMEDICINE 2209 SOUTH AVE SOUTH LAKE TAHOE CA 96150 PSYCHIATRY & TELEMEDICINE 15 - BARTON HOME HEALTH & HOSPICE 155 HIGHWAY 50 STATELINE NV 89449 HOME HEALTH & HOSPICE SERVICES 16 - BARTON WOMEN'S HEALTH 2175 SOUTH AVENUE SOUTH LAKE TAHOE CA 96150 WOMEN'S HEALTH CLINIC 17 - BARTON PSYCHIATRY 155 HIGHWAY 50 STATELINE NV 89449 PSYCHIATRY CLINIC 18 - BARTON MEDICAL CLINIC AT SIERRA-AT-TAHOE 1111 SIERRA-AT-TAHOE ROAD TWIN BRIDGES CA 95735 SEASONAL MEDICAL SKI CLINIC 19 - BARTON MEDICAL CLINIC AT KIRKWOOD MTN 1501 KIRKWOOD MEADOWS DRIVE KIRKWOOD CA 95646 SEASONAL MEDICAL SKI CLINIC 20 - BARTON PALLIATIVE CARE & ONCOLOGY 1067 FOURTH STREET SOUTH LAKE TAHOE CA 96150 PALLIATIVE CARE AND ONCOLOGY CLINIC 21 - BARTON MEDICAL CLINIC AT HEAVENLY MTN 3860 SADDLE ROAD SOUTH LAKE TAHOE CA 96150 SEASONAL MEDICAL SKI CLINIC 22 - COVID CLINIC 2158 JEAN STREET SOUTH LAKE TAHOE CA 96150 COVID CLINIC 23 - BARTON CARDIOLOGY NV & BARTON PHYSICAL AND 155 HIGHWAY 50 STATELINE NV 89449 CARDIOLOGY, PHYSICAL MEDICINE & REHABILIATION PART I, LINE 3C: IN ADDITION TO THE FPG, THE HOSPITAL CONSIDERS IF THE PATIENT IS UNINSURED AND/OR UNDERINSURED WHEN DETERMINING IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE. PART I, LINE 7: THE COSTING METHODOLOGY USED THE OVERALL COST TO CHARGE RATIO OBTAINED FOR EACH PATIENT SEGMENT AND APPLIED AGAINST GROSS CHARGES FROM THE 2021 COST REPORT. THIS RATIO WAS USED FOR LINES 7A, 7B AND 7G. ACTUAL OPERATING COSTS WERE USED TO CALCULATE LINES 7E, 7F, AND 7I. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES COMMUNITY BENEFIT EXPENSES AND DIRECT OFFSETTING REVENUE RELATED TO PHYSICIAN CLINICS. TOTAL COMMUNITY BENEFIT EXPENSES WERE $1,156,172 AND DIRECT OFFSETTING REVENUE WAS $4,780,897. PART II, COMMUNITY BUILDING ACTIVITIES: EMERGENCY MANAGEMENT PREPAREDNESS: BARTON HEALTH CHAIRS AND HOSTS THE EMERGENCY MANAGEMENT COMMUNITY COUNCIL. THIS COUNCIL MEETS EVERY OTHER MONTH WITH AREA AGENCIES TO DISCUSS EMERGENCY PREPAREDNESS AND EDUCATION TO THE SOUTH LAKE TAHOE COMMUNITY. EXERCISE DRILLS, EMERGENCY PREPAREDNESS MATERIALS AND OTHER PROGRAMS COME OUT OF THIS GROUP. THE GROUP WAS DESIGNED WITH THE HEALTH AND SAFETY OF OUR COMMUNITY IN MIND. THE GROUP INCLUDES REPRESENTATIVES FROM BARTON HEALTH, RED CROSS, EL DORADO COUNTY HEALTH AND HUMAN SERVICES, AREA FIRE DEPARTMENTS, POLICE, SHERIFF, HAM RADIO, SCHOOL DISTRICTS, PUBLIC UTILITIES AND OTHER REPRESENTATIVES WHO WOULD HAVE A RESPONSE CAPABILITY IN OUR COMMUNITY. THE PURPOSE IS TO PROTECT THE HEALTH OF OUR COMMUNITY BY BEING PREPARED FOR DISASTERS, AND KNOWING OUR EMERGENCY PARTNERS IN THE EVENT OF AN EMERGENCY TO BETTER FORM A COHESIVE RESPONSE IN THE SOUTH LAKE TAHOE AREA, WHICH WILL ASSIST IN GETTING THE COMMUNITY BACK ON ITS FEET AFTER A DISASTER. THE IMPACT OF THIS PROGRAM IS THE COORDINATION AMONGST LOCAL EMERGENCY PROVIDERS TO ENSURE EMERGENCY READINESS FOR THE NEXT LOCAL DISASTER. BARTON HEALTH FURTHER SUPPORTS VARIOUS ORGANIZATIONS BY PROVIDING HEALTH GRANTS, SPONSORSHIPS AND OTHER SUPPORT. BARTON HEALTH ADDITIONALLY ASSISTS OUR NEEDY PATIENTS BY ASSISTING WITH TRANSPORTATION COSTS AND MEDICATION.COALITION BUILDING: BARTON HEALTH HOSTS THE COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC)THAT IS A COLLABORATIVE OF REPRESENTATIVES OF VARIOUS COMMUNITY AGENCIES AND COMMUNITY MEMBERS THAT MEETS MONTHLY TO ADDRESS TOP COMMUNITY HEALTH NEEDS AS THEY EMERGE.WORKFORCE DEVELOPMENT: BARTON HEALTH FACILITIES ARE DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND TO MAINTAIN PATIENT ACCESS TO ESSENTIAL SERVICES IN OUR COMMUNITY, THE ORGANIZATION INCURS RECRUITMENT COSTS FOR VARIOUS PROVIDERS. BARTON IS A MEMBER OF THE IHCC -INTER HOSPITAL COORDINATION COUNCIL - WHICH IS SPONSORED BY WASHOE COUNTY AND THE QUAD COUNTIES HEALTHCARE COALITION WHICH IS SPONSORED BY DOUGLAS COUNTY. PART III, LINE 2: THE AMOUNT OF BAD DEBT REPORTED ON LINE 2 IS BASED ON CHARGES. IN 2018, THE HEALTHCARE SYSTEM ADOPTED ASU 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS WHICH CHANGED THE METHODOLOGY ON THE CALCULATION AND REPORTING OF BAD DEBT EXPENSE. PART III, LINE 4: GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HEALTHCARE SYSTEM ALSO PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HEALTHCARE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FOR THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. THE HEALTHCARE SYSTEM DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY IN CERTAIN CIRCUMSTANCES AND FOR CERTAIN SERVICES. BAD DEBT EXPENSE IS RECORDED WHEN THERE IS AN ADVERSE CHANGE IN THESE PATIENT'S ABILITY TO PAY. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, WAS $897,184 AND $821,101, RESPECTIVELY. PART III, LINE 8: THE ORGANIZATION PROVIDES A BROAD RANGE OF SERVICES TO ITS MEDICARE PATIENTS WITHOUT REGARD TO REVENUE REALIZED FROM THE SERVICES PROVIDED.THE ORGANIZATION IS A RURAL HOSPITAL WITH THE NEAREST ADDITIONAL HOSPITAL APPROXIMATELY 36 MILES AWAY. COSTS EXCLUDED FROM THE ORGANIZATION'S MEDICARE COST REPORT INCLUDE COSTS ASSOCIATED WITH PHYSICIAN CLINICS, THE AUXILIARY, COMMUNITY RELATIONS, AND OTHER NON-REIMBURSABLE COSTS. THE ORGANIZATION UTILIZES THE COST TO CHARGE RATIO AS PROVIDED IN ITS ANNUAL COST REPORT. PART III, LINE 9B: THE ORGANIZATION FOLLOWS ALL CHARITY AND COLLECTION GUIDELINES AS OUTLINED IN SB774, THE CALIFORNIA HEALTH AND SAFETY CODE SECTION 127425, AND CMS MEDICARE GUIDELINES. PART VI, LINE 2: BARTON HEALTH IS A MEMBER OF NUMEROUS COMMUNITY COLLABORATIVES WORKING TO ADDRESS THE HEALTH NEEDS IN OUR COMMUNITY. BARTON PARTICIPATES IN THE COMMUNITY BEHAVIORAL HEALTH NETWORK COMMITTEE WHICH FOCUSES ON COORDINATING MENTAL HEALTH SERVICES AMONGST OUR COMMUNITY PROVIDERS. WE LEAD THE COMMUNITY HEALTH ADVISORY COMMITTEE, WITH OUR TOP THREE HEALTH PRIORITIES DETERMINING HOW FUNDING AND RESOURCES ARE UTILIZED. ADDITIONALLY, WE ATTEND THE MONTHLY LAKE TAHOE COLLABORATIVE, FOCUSING ON COLLABORATIONS FOR YOUTH; AND WE FILL THE HEALTHCARE SEAT ON OUR COMMUNITY'S DRUG-FREE COMMUNITY COALITION. PART VI, LINE 3: EVERY SELF-PAY PATIENT IS SCREENED FOR ELIGIBILITY UNDER OUR FINANCIAL ASSISTANCE POLICY WHICH BEGINS AT ADMISSION OR WHEN OTHERWISE FEASIBLE. IN ADDITION, REFERENCE TO OUR FINANCIAL ASSISTANCE PROGRAM IS POSTED AT THE EMERGENCY ROOM AND ADMITTING DEPARTMENTS, DISCLOSED ON OUR WEBSITE, REFERENCED TO IN THE PATIENT HANDBOOK, AND ON PATIENT BILLING STATEMENTS. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR BARTON MEMORIAL HOSPITAL SITS WITHIN THE SIERRA NEVADA MOUNTAINS ON THE BORDER BETWEEN CALIFORNIA AND NEVADA. THIS AREA ENCOMPASSES THE SOUTH LAKE TAHOE BASIN FROM TAHOMA, CA ON THE WEST THROUGH GLENBROOK, NV ON THE EAST. THE DEMOGRAPHICS FOR THIS AREA ARE AS FOLLOWS: APPROXIMATELY 54% MALE AND 46% FEMALE; 20.6% UNDER THE AGE OF 18, 11.6% AGED 18 TO 24, 30.0% AGED 25 TO 44, 28.1% AGED 45 TO 64, AND 9.8% WHO WERE 65 YEARS OF AGE OR OLDER; 63.5% ARE CAUCASIAN, 28% ARE HISPANIC AND 8.5% REPRESENT OTHER RACES, 13% OF THE COMMUNITY IS LOW INCOME BELOW THE 200% FEDERAL POVERTY LEVEL. PART VI, LINE 5: AS DESCRIBED IN THE COMMUNITY BENEFIT SECTION OF THE 990, BARTON HEALTH CONTRIBUTES TO OUR COMMUNITY'S HEALTH IN A VARIETY OF WAYS: OUR GOVERNING BODY IS REPRESENTED BY INDIVIDUALS OF OUR COMMUNITY. SURPLUS FUNDS ARE USED TO MAINTAIN A HIGH LEVEL OF PATIENT CARE THROUGH REINVESTMENT. BARTON HEALTH HAS ON OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. OUR LABORATORY OFFERS DISCOUNTED LAB DRAWS; NUMEROUS PHYSICIANS AND EMPLOYEES PARTICIPATE IN OUR FREE COMMUNITY WELLNESS LECTURES; OUR EMERGENCY DEPARTMENT PARTICIPATES IN YOUTH EDUCATION PROGRAMS AND THE DRUG STORE PROJECT; MANY OF OUR NURSES AND PRACTITIONERS PARTICIPATE IN OFFERING MEDICAL COVERAGE FOR SPECIAL EVENTS THROUGHOUT THE COMMUNITY; BARTON PRIMARY CARE OFFER FREE STUDENT SPORTS PHYSICALS; BARTON HEALTH DONATES TO AND SPONSORS YOUTH PROGRAMS AND LOCAL NON-PROFIT ORGANIZATIONS; STAFF FROM VARIOUS DEPARTMENTS LIKE BARTON EDUCATION, FAMILY BIRTHING CENTER, BARTON REHABILITATION PARTICIPATE IN COMMUNITY EVENTS AND HAVE INFORMATION AND EDUCATIONAL BOOTHS FOR THE COMMUNITY; BARTON MEMORIAL HOSPITAL OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 BARTON MEMORIAL HOSPITAL FOUNDATION INC PO BOX 529 ZEPHYR COVE NV 89448 880268799 501(C)(3) 315017 0 OVERHEAD FUNDING BOYS AND GIRLS CLUB OF SLT 1100 LYONS AVE SOUTH LAKE TAHOE CA 96150 680241891 501(C)(3) 10600 0 COMMUNITY GRANT HUMANGOOD AFFORDABLE HOUSING 6120 STONERIDGE MALL ROAD STE 100 PLEASANTON CA 945883187 943085296 501(C)(3) 6500 0 COMMUNITY GRANT SOS OUTREACH PO BOX 2020 AVON CO 81620 841332544 501(C)(3) 10000 0 COMMUNITY GRANT TAHOE COALITION FOR THE HOMELESS PO BOX 13514 SOUTH LAKE TAHOE CA 96150 474825924 501(C)(3) 10000 0 COMMUNITY GRANT COUNTY OF EL DORADO 6767 GREEN VALLEY ROAD PLACERVILLE CA 95667 942317114 GOVERNMENT 10000 0 COMMUNITY GRANT BREAD & BROTH 1041 LYONS AVE SOUTH LAKE TAHOE CA 96150 453954503 501(C)(3) 10000 0 COMMUNITY GRANT LIVE VIOLENCE FREE 2941 LAKE TAHOE BLVD SOUTH LAKE TAHOE CA 96150 942598256 501(C)(3) 10000 0 COMMUNITY GRANT EL DORADO COMMUNITY FOUNDATION 312 MAIN ST 201 PLACERVILLE CA 95667 680255556 501(C)(3) 6500 0 COMMUNITY GRANT FAMILY RESOURCE CENTER 3501 SPRUCE AVE B SOUTH LAKE TAHOE CA 96150 942284118 501(C)(3) 10000 0 COMMUNITY GRANT CARSON VALLEY MEDICAL CENTER 1107 US HWY 395 GARDNERVILLE NV 89410 880405927 501(C)(3) 7500 0 COMMUNITY GRANT 10 1 PATIENT ASSISTANCE 87 28858 PART I, LINE 2: THE ORGANIZATION PAYS THE GENERAL OVERHEAD EXPENSES OF BMH FOUNDATION (A RELATED 501(C)(3)). FOR 2021 - THE TOTAL AMOUNT FUNDED WAS $315,017. THE ORGANIZATION PROVIDES ASSISTANCE TO VARIOUS PATIENTS IN NEED INCLUDING PRESCRIPTION MEDICATION, TAXI FARE, LODGING, ETC. TOTAL PATIENT ASSISTANCE PROVIDED DURING 2021 TOTALED $28,858. ADDITIONALLY, FUNDS DONATED TO VARIOUS COMMUNITY GROUPS TOTALED $139,743. X X X X X 1 0 0 0 0 0 0 1 0 CLINTON PURVANCE MD CEO 488570 133938 181611 0 36182 122847 14500 0 30443 8622 751306 265407 0 0 DEANNA KYRIMIS CHIEF AMBULATORY OPERATIONS OFFICER 273149 0 121017 0 258302 0 2900 0 23414 0 678782 0 0 0 MATTHEW WONNACOTT CHIEF MEDICAL OFFICER 456825 0 137580 0 3019 0 14500 0 27775 0 639699 0 0 0 JULIE CLAYTON CHIEF NURSING OFFICER 391955 0 116632 0 41097 0 12686 0 21700 0 584070 0 0 0 KELLY NEIGER CFO 299242 81965 122635 0 23168 697 13910 0 30443 7384 489398 90046 0 0 ELIZABETH STORK CHIEF HUMAN RESOURCES OFFICER 274296 75289 104677 500 2323 36308 7920 3243 912 274 390128 115614 0 0 JEFFREY KOECK DIRECTOR OF PHARMACY 213014 0 11976 0 20340 0 6527 0 35457 0 287314 0 0 0 JULIE HOWES CONTROLLER 209943 0 13705 0 17958 0 9217 0 11067 0 261890 0 0 0 SIOBHAN KELLER DIRECTOR OF NURSING 198508 0 11372 0 10702 0 10416 0 29075 0 260073 0 0 0 KAITLYN MIDDLEMIS-CLARK PHARMACIST 225590 0 4308 0 0 0 6975 0 0 0 236873 0 0 0 DANA RANDALL PHYSICIANS ASSISTANT 196554 0 3062 0 14936 0 0 0 13122 0 227674 0 0 0 PART I, LINE 7 BARTON GIVES ANNUAL PERFORMANCE BASED BONUSES FOR EMPLOYEES IF CERTAIN CRITERIA ARE MET, INCLUDING FINANCIAL PERFORMANCE TO BUDGET, AND GOALS SET PER POLICY. IN ADDITION, BARTON GAVE BONUSES TO EMPLOYEES IN THE FORM OF ADDING ETO TO EMPLOYEE BANKS DURING THE FIRE EVACUATION, AND GAVE BONUSES TO VARIOUS EMPLOYEES FOR FIRE EVACUATION ASSISTANCE. A CITY OF SOUTH LAKE TAHOE 941610868 NONEAVAIL 2015-11-03 20000000 EQUIP & CAPITAL IMPROVEMENTS 0 0 0 B CITY OF SOUTH LAKE TAHOE 941610686 NONEAVAIL 2014-06-12 18000000 EQUIPMENT 0 0 0 A 17254411 20000000 182408 19817592 2017 0 0 0 1 B 8029585 18000000 249697 17750303 2017 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 MICHAEL NEIGER SPOUSE OF OFFICER - KELLY NEIGER, CFO 130319 EMPLOYEE 0 MICHAEL FRY BROTHER OF BOARD MEMBER - PATRICK FRY 92396 INDEPENDENT CONTRACTOR 0 CATHERINE BAGDIKIAN DAUGHTER OF BOARD MEMBER - PAT BAGHDIKAN 21701 EMPLOYEE 0 X 211600 THIRFT SHOP VALUE 0 0 1 0 FORM 990, PART III, LINE 2 FOOD INSECURITY PROGRAM: WE CONTINUED OUR PARTNERSHIP WITH WHOLE FOODS WHILE EXPANDING OUR DISTRIBUTION OF HIGH-QUALITY FOOD TO LOCAL PANTRIES, INDIVIDUALS, FAMILIES, AND FAITH-BASED ORGANIZATIONS. THROUGH OUR PARTNERSHIP WITH THE FOOD DONATION CONNECTION, WE ALSO ADDED STARBUCK'S AS A PARTNER WHICH PROVIDED ADDITIONAL FRESH FOOD AND PASTRIES TO DISTRIBUTE THROUGHOUT OUR COMMUNITY. WE EXPANDED OUR FOOD DISTRIBUTION TO 3-DAYS PER WEEK AS WELL AS ADDING ADDITIONAL DATES AS NECESSARY WHEN OUR PARTNERS WERE NOT ABLE TO PICK UP. COMMUNITY COVID CALLS: BARTON HEALTH COORDINATED WEEKLY COMMUNITY CALLS WITH BUSINESS OWNERS AND CLERGY LEADERS THROUGHOUT 2021. THESE WERE HOSTED BY OUR CEO AND HIS LEADERSHIP TEAM. SCHOOL DISTRICT HEALTH AND WELLNESS SERVICES: BARTON HEALTH PARTNERED WITH THE LAKE TAHOE UNIFIED SCHOOL DISTRICT TO OFFER PHYSICIAN LEADERSHIP, PR SUPPORT, AND OPERATIONAL DEVELOPMENT TO HELP ESTABLISH POLICIES AND PROCEDURES INTENDED TO PROVIDE THE SAFEST POSSIBLE ENVIRONMENT FOR STUDENTS TO RETURN TO SCHOOL DURING THE PANDEMIC. COMMUNITY-BASED MOBILE VACCINATION CLINICS: BARTON HELPED SUPPORT THE FAMILY RESOURCE CENTER TO HOST A MOBILE VACCINATION CLINIC FOCUSED ON EDUCATING AND SERVING OUR LATINO AND FILIPINO COMMUNITY MEMBERS. THROUGH A PARTNERSHIP WITH EL DORADO COUNTY, THE STATE OF CALIFORNIA, AND THE SNAPNURSE MOBILE CLINIC TEAM, OVER 60 COMMUNITY MEMBERS RECEIVED THE VACCINE AT OUR BIJOU ELEMENTARY LOCATION. BARTON PARTNERED WITH THE BOYS & GIRLS CLUB, ALONG WITH THE CITY OF SOUTH LAKE TAHOE AND SOUTH LAKE TAHOE FIRE RESCUE TO HELP ADMINISTER PEDIATRIC VACCINES TO 140 CHILDREN. BARTON PARTNERED WITH OUR LOCAL SOUTH TAHOE HIGH SCHOOL TO OFFER ON CAMPUS VACCINATIONS FOR THAT AGE GROUP. 58 STUDENTS WERE VACCINATED IN THIS ONE-DAY EVENT. FORM 990, PART VI, SECTION A, LINE 2 KIRK LEDBETTER AND JEFF RAHBECK HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES TO BHC MSO, LLC. BHC MSO, LLC EMPLOYS KELLY NEIGER, CLINTON PURVANCE, AND ELIZABETH STORK. FORM 990, PART VI, SECTION A, LINE 6 THERE ARE TWO CLASSES OF MEMBERS IN THE ORGANIZATION: VOTING MEMBERS AND ASSOCIATE MEMBERS. CLASS I VOTING MEMBERS ARE THOSE INDIVIDUALS WHO HAVE CONTRIBUTED $200 OR MORE PRIOR TO JULY 11, 1986. EACH CLASS I VOTING MEMBER HAS THE RIGHT TO CAST 1 VOTE, BUT NOT MORE THAN 5 VOTES FOR EACH $200 CONTRIBUTION. CLASS II VOTING MEMBERS ARE THOSE INDIVIDUALS ADMITTED AFTER JULY 11, 1986 AND PRIOR TO JULY 1, 2010 WHO HAVE CONTRIBUTED $1,000 OR MORE. EACH CLASS II VOTING MEMBER HAS THE RIGHT TO CAST 1 VOTE, BUT NOT MORE THAN 5 VOTES, FOR EACH $1,000 CONTRIBUTION. CLASS III VOTING MEMBERS ARE THOSE INDIVIDUALS ADMITTED AFTER JULY 1, 2010 WHO HAVE CONTRIBUTED $1,500 OR MORE. EACH CLASS III VOTING MEMBER HAS THE RIGHT TO CAST 1 VOTE. ASSOCIATE MEMBERS DO NOT HAVE VOTING RIGHTS. MEMBERS DO NOT HAVE THE RIGHT TO APPROVE SIGNIFICANT DECISIONS NOR RECEIVE DISTRIBUTIONS UPON DISSOLUTION. FORM 990, PART VI, SECTION A, LINE 7A THE CHAIRMAN OF THE ORGANIZATION SHALL APPOINT A COMMITTEE OF NOT MORE THAN 5 NOR LESS THAN 3 MEMBERS OF THE ORGANIZATION TO SERVE AS A NOMINATING COMMITTEE IN THE ELECTION OF THE BOARD OF DIRECTORS. ANY 7 MEMBERS MAY ALSO NOMINATE CANDIDATES FOR DIRECTOR. IF MORE PEOPLE ARE NOMINATED FOR THE BOARD THAN CAN BE ELECTED, MEMBERS ARE PERMITTED TO VOTE AND THE CANDIDATES RECEIVING THE HIGHEST NUMBER OF VOTES SHALL BE ELECTED. FORM 990, PART VI, SECTION A, LINE 7B BYLAW AMENDMENTS ARE SUBJECT TO APPROVAL BY THE VOTING MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B EACH MEMBER OF THE GOVERNING BOARD OF DIRECTORS AND OFFICERS ARE PROVIDED WITH AN ELECTRONIC COPY OF THE FORM 990 FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE GOVERNING BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE PURSUANT TO WRITTEN POLICY, THE BOARD MEMBERS ARE PRECLUDED FROM PARTICIPATING IN DEBATE AND VOTING ON ANY ISSUE IN WHICH THE MEMBER(S) (OR FAMILY MEMBER) MAY HAVE A PERSONAL OR BUSINESS INTEREST. THE BOARD CHAIR AND/OR HOSPITAL COUNSEL WILL DETERMINE IF THERE IS A CONFLICT. EMPLOYEES ARE PROVIDED WITH A COPY OF THE CONFLICT OF INTEREST POLICY THAT IS WITHIN AN ELECTRONIC POLICY SOFTWARE PROGRAM THAT REQUIRES EMPLOYEES TO MARK AS READ AS NEW HIRES OR AS CHANGES ARE MADE AND ARE MONITORED BY THEIR IMMEDIATE SUPERVISORS. EMPLOYEES ARE REQUIRED TO BE FAMILIAR WITH THE POLICY AT ALL TIMES. THEY DO NOT FORMALLY REVIEW THE POLICY ANNUALLY BUT ARE REQUIRED TO STILL DISCLOSE ANY POTENTIAL CONFLICTS THAT MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION ENGAGED AN INDEPENDENT FIRM TO CONDUCT AN EXECUTIVE COMPENSATION SURVEY. THE INDEPENDENT FIRM ISSUED A CERTIFICATION OF REASONABLENESS UPON COMPARING EXECUTIVE COMPENSATION WITH SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE CONSISTING OF BOARD MEMBERS REVIEWS THE CEO COMPENSATION AND APPROVES CHANGES TO THE EXECUTIVE TEAM'S CONTRACTS. THE COMMITTEE SUBSTANTIATES THIS PROCESS IN THEIR MINUTES. THE CEO APPROVES THE COMPENSATION FOR THE REMAINING EXECUTIVE TEAM USING DATA OBTAINED FROM ANNUAL SURVEYS PERFORMED BY THE CALIFORNIA HEALTHCARE ASSOCIATION AND/OR INDEPENDENT COMPENSATION EVALUATION FIRMS AS WELL AS COMPARISONS OF SPECIFIC COMPENSATION OF EXECUTIVES FROM SIMILAR-SIZED HOSPITALS BOTH IN CALIFORNIA AND NATIONWIDE. BARTON HEALTHCARE SYSTEM IS A BI-STATE HEALTHCARE PROVIDER THAT INCLUDES A LICENSED 63-BED FULL-SERVICE HOSPITAL WITH A 24-HOUR EMERGENCY ROOM; DESIGNATED LEVEL III TRAUMA CENTER; 48-BED SKILLED NURSING AND LONG-TERM CARE FACILITY; STATE OF THE ART OPERATING ROOMS AND REHABILITATION DEPARTMENTS; CENTER OF ORTHOPEDICS AND WELLNESS; HOME HEALTH, HOSPICE AND PALLIATIVE CARE SERVICES; LAKE TAHOE SURGERY CENTER; 50% OWNERSHIP IN CARSON VALLEY MEDICAL CENTER (A FULL-SERVICE HOSPITAL LOCATED IN THE CARSON VALLEY); SATELLITE LAB FACILITIES; BARTON EDUCATION (PROVIDING CLINICAL AND COMMUNITY HEALTH EDUCATION); BARTON AUXILIARY; AND BARTON MEMORIAL HOSPITAL FOUNDATION (A 501(C)(3) SUPPORTING ORGANIZATION). THE SYSTEM FURTHER INCLUDES 23 OUTPATIENT PHYSICIAN CLINICS WHICH ENCOMPASS ORTHOPEDIC CLINICS, OB/GYN CLINICS, PEDIATRICS, INTERNAL MEDICINE, PERFORMANCE, MULTI-SPECIALTY GENERAL SURGERY/GI, PLASTIC SURGERY, RHEUMATOLOGY/WELLNESS, PHYSIATRY, PALLIATIVE CARE, CARDIOLOGY, NEUROLOGY, UROLOGY, ENT/AUDIOLOGY, URGENT CARE/OCCUPATIONAL HEALTH CLINICS, FAMILY CARE CLINICS, LOW-INCOME RURAL HEALTH CLINIC, BEHAVIORAL HEALTH AND SEASONAL SKI CLINICS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS REQUIRING PUBLIC DISCLOSURE ARE AVAILABLE UPON REQUEST AND ARE POSTED ON THE ORGANIZATION'S WEBSITE: WWW. BARTONHEALTH.ORG. ORGANIZATION CONTACT MINDI BEFU 530-543-5601 FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 208,326. MANAGEMENT AND GENERAL EXPENSES 2,851,338. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,059,664. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,369,656. MANAGEMENT AND GENERAL EXPENSES 2,256,572. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,626,228. MEDICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,275,935. MANAGEMENT AND GENERAL EXPENSES 103,944. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,379,879. TEMPORARY PERSONNEL: PROGRAM SERVICE EXPENSES 8,771,722. MANAGEMENT AND GENERAL EXPENSES 4,239,221. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,010,943. MEDICAL FEES: PROGRAM SERVICE EXPENSES 30,116,743. MANAGEMENT AND GENERAL EXPENSES 451,655. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,568,398. 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